The Complete Blood Count: Increasing Its Precision and Impact
Authors: W. Richard Burack, Marshall A. Lichtman
Journal: Annals of Internal Medicine (2023)

Ideas and OpinionsMarch 2023The Complete Blood Count: Increasing Its Precision and ImpactW. Richard Burack, MD, PhD and Marshall A. Lichtman, MDW. Richard Burack, MD, PhDDepartment of Pathology and Laboratory Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York (W.R.B.) and Marshall A. Lichtman, MDDepartment of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York (M.A.L.).Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M22-3071 Annals Author Insight Video - W. Richard Burack, MD, PhD In this video, W. Richard Burack, MD, PhD, offers additional insight into the article, "The Complete Blood Count: Increasing Its Precision and Impact." (Duration 3:20) SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The complete blood count (CBC) was created about 85 years ago and is ordered several hundred million times a year in the United States. Today's typical CBC reports 19 different values, some of which are unnecessary because they are redundant or inconsequential. They can cause harm by distracting clinicians and can create unnecessary patient concern—for example, when a patient sees a value that is outside the "normal" range but is not clinically relevant. We believe that patients and clinicians would benefit from a more succinct and impactful way to order a CBC. We propose 3 distinct CBCs to replace the ...References1. Shalev O, Yehezkel E, Rachmilewitz EA. Inadequate utilization of routine electronic RBC counts to identify beta thalassemia carriers. Am J Public Health. 1988;78:1476-7. [PMID: 3177725] CrossrefMedlineGoogle Scholar2. Simel DL, DeLong ER, Feussner JR, et al. Erythrocyte anisocytosis. Visual inspection of blood films vs automated analysis of red blood cell distribution width. Arch Intern Med. 1988;148:822-4. [PMID: 3355302] CrossrefMedlineGoogle Scholar3. Salvagno GL, Sanchis-Gomar F, Picanza A, et al. Red blood cell distribution width: a simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci. 2015;52:86-105. [PMID: 25535770] doi:10.3109/10408363.2014.992064 CrossrefMedlineGoogle Scholar4. Li N, Zhou H, Tang Q. Red blood cell distribution width: a novel predictive indicator for cardiovascular and cerebrovascular diseases. Dis Markers. 2017;2017:7089493. [PMID: 29038615] doi:10.1155/2017/7089493 CrossrefMedlineGoogle Scholar5. Åsberg AE, Mikkelsen G, Aune MW, et al. Empty iron stores in children and young adults—the diagnostic accuracy of MCV, MCH, and MCHC. Int J Lab Hematol. 2014;36:98-104. [PMID: 23941574] doi:10.1111/ijlh.12132 CrossrefMedlineGoogle Scholar6. Brugnara C, Mohandas N. Red cell indices in classification and treatment of anemias: from M.M. Wintrobes's original 1934 classification to the third millennium. Curr Opin Hematol. 2013;20:222-30. [PMID: 23449069] doi:10.1097/MOH.0b013e32835f5933 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: W. Richard Burack, MD, PhD; Marshall A. Lichtman, MDAffiliations: Department of Pathology and Laboratory Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York (W.R.B.)Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York (M.A.L.).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-3071.Corresponding Author: Marshall A. Lichtman, MD, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, 601 Elmwood Avenue, WCC 3-0760A, Rochester, NY 14642; e-mail, marshall_lichtman@urmc.rochester.edu.Author Contributions: Conception and design: W.R. Burack, M.A. Lichtman.Drafting of the article: W.R. Burack, M.A. Lichtman.Critical revision for important intellectual content: W.R. Burack, M.A. Lichtman.Final approval of the article: W.R. Burack, M.A. Lichtman.This article was published at Annals.org on 31 January 2023. PreviousarticleNextarticle Advertisement Annals Author Insight Video - W. Richard Burack, MD, PhD In this video, W. Richard Burack, MD, PhD, offers additional insight into the article, "The Complete Blood Count: Increasing Its Precision and Impact." (Duration 3:20) FiguresReferencesRelatedDetailsSee AlsoAnnals On Call - The Complete Blood Count: Cleaning Up the Clutter Robert M. Centor , W. Richard Burack , and Marshall A. Lichtman The Complete Blood Count: Increasing Its Precision and Impact W. Richard Burack , and Marshall A. Lichtman The Complete Blood Count: Increasing Its Precision and Impact Stephen D. Sisson The Complete Blood Count: Increasing Its Precision and Impact Marko Lucijanic , and Ivan Krecak Metrics Cited byThe Complete Blood Count: Increasing Its Precision and ImpactStephen D. Sisson, MDThe Complete Blood Count: Increasing Its Precision and ImpactMarko Lucijanic, MD, PhD, and Ivan Krecak, MD, PhD March 2023Volume 176, Issue 3Page: 404-405KeywordsAnemiaComplete blood countHematocritIron deficiencyMean corpuscular hemoglobinMean corpuscular hemoglobin concentrationMean corpuscular volumeRed blood cellsReticulocytesWhite blood cells ePublished: 31 January 2023 Issue Published: March 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...